茶碱类药物在急性心力衰竭治疗中的过去与现在

doi:10.3969/j.issn.1002-1949.2018.01.006

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摘要茶碱为甲基黄嘌呤衍生物，具有增强心脏收缩、改善心脏血流动力学及利尿作用，在过去的几十年里，茶碱类药物已广泛应用于哮喘、慢性阻塞性肺部疾病（COPD）、支气管炎等疾病。过去认为，茶碱在急性心力衰竭（AHF）治疗中起到积极作用，但目前在AHF临床指南中已不把茶碱作为治疗推荐用药。本文从茶碱药理作用、药代学以及药效学，阐述其在AHF中的问题及目前应用情况，深刻认识茶碱在AHF治疗中的过去与现在。

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	陈潇荣
	卢中秋

收稿日期: 2017-12-14

通讯作者: 卢中秋（1964-），男，主任医师，博士生导师，E-mail:lzq640815@163.com。

引用本文:

陈潇荣，卢中秋. 茶碱类药物在急性心力衰竭治疗中的过去与现在[J]. 中国急救医学, 2018, 38(1): 23-25.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.01.006 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I1/23

［1］Parker JO, Kelly G, West RO. Hemodynamic effects of aminophylline in heart failure［J］. Am J Cardiol, 1966, 17(2)：232-239. ［2］Marcus ML, Skelton CL, Prindle KH, et al. Effects of theophylline on myocardial mechanics［J］. Am J Physiol, 1972, 222:1361-1365. ［3］Uedo H, Nakanishi A, Shiba M, et al. The acute effect of aminophylline on left ventricular function in patients with heart failure［J］. Jpn Heart J, 1966, 8:121-131. ［4］Parker JO, Kelly G, West RO. Hemodynamic effects of aminophylline in heart failure［J］. Am J Cardiol, 1966, 17:232-239. ［5］Barbour MM, Garber CE, Ahlberg AW. Effects of intravenous theophylline on exercise-induced myocardial ischemia: Ⅱ. A concentration-dependent phenomenon［J］. J Am Coll Cardiol, 1993, 22(4):1155-1158. ［6］Crea F, Gaspardone A, Araujo L, et al. Effects of aminophylline on cardiac function and regional myocardialperfusion: Implications regarding its antiischemicaction［J］. Am Heart J, 1994, 127:817-824. ［7］Radice M, Giudici V, Pusineri E. Different effects of acute administration of aminophylline and nitroglycerin on exercise capacity in patients with syndrome［J］. Am J Cardiol, 1996, 78(1):88-92. ［8］Steinberg FU, Smith JR, Jensen J. The clinical value of theophylline in heart disease［J］. Am Heart J, 1950, 40(5):798-804. ［9］Tomcsányi J, Karlócai K. Effect of theophylline on periodic breathing in congestive heart failure measured by transcutaneous oxygen monitoring［J］. Eur J Clin Pharmacol, 1994, 46(2):173-174. ［10］Mudge GH. Drugs affecting renal function and electrolyte metabolism//The Pharmacologic Basis of Therapeutics, ed. 5, ed. by Goodman and Gilman［M］. New York: McGraw-Hill, 1975, 839-840. ［11］Jenne JW. Effect of disease states on theophylline elimination［J］. J Allergy Clin Immunol, 1986, 78(4 Pt 2):727-735. ［12］Trger U, Meyer FP. Influence of endogenous and exogenous effectors on the pharmacokinetics of theophylline. Focus on biotransformation［J］.Clin Pharmacokinet, 1995, 28(4):287-314. ［13］Ogawa R, Stachnik JM, Echizen H. Clinical pharmacokinetics of drugs in patients with heart failure: an update(part 1, drugs administered intravenously)［J］. Clin Pharmacokinet, 2013, 52(3):169-185. ［14］Mitenko PA, Ogilvie RI. Rational intravenous doses of theophylline［J］. N Engl J Med, 1973, 289(12):600-603. ［15］Duffy N, Walker P, Diamantea F.Intravenous aminophylline in patients admitted to hospital with non-acidotic exacerbations of chronic obstructive pulmonary disease: a prospective randomised controlled trial［J］. Thorax, 2005, 60(9):713-717. ［16］Patel AK, Skatrud JB, Thomsen JH. Cardiac arrhythmias due to oral aminophylline in patients with chronic obstructive pulmonary disease［J］. Chest, 1981, 80(6):661-655. ［17］Marchlinski FE, Miller JM. Atrial arrhythmias exacerbated by theophylline. Response to verapamil and evidence for triggered activity in man［J］. Chest, 1985, 88(6):931-934. ［18］Huerta C, Lanes SF, García Rodríguez LA. Respiratory medications and the risk of cardiac arrhythmias［J］. Epidemiology, 2005, 16(3)：360-366. ［19］Mohamad N, AbdHalim NN. Theophylline toxicity: A case report of the survival of an undiagnosed patient who presented to the emergency department［J］. Malays J Med Sci, 2009, 16(2):33-37. ［20］Robertson NJ. Fatal overdose from a sustained-release theophylline preparation［J］. Ann Emerg Med, 1985, 14(2):154-158. ［21］Davies RJ, Hawkey CJ. Fatal theophylline toxicity precipitated by in situ pulmonary artery thrombosis［J］. Postgrad Med J, 1989, 65(759):49-50. ［22］DiBianco R, Rosenfeld SP, Katz RJ. Role of aminophylline in refractory heart failure: a comparison to the vasodilator sodium nitroprusside, the old and the new［J］. Clin Cardiol, 1980, 3(4):268-275. ［23］Hopkins ME, MacKenzie-Ross RV. Case Report: The risks associated with chronic theophylline therapy and measures designed to improve monitoring and management［J］. BMC Pharmacol Toxicol, 2016, 17:13. ［24］Andreas S, Reiter H, Lüthje L. Differential effects of theophylline on sympathetic excitation, hemodynamics, and breathing in congestive heart failure［J］. Circulation, 2004, 110(15):2157-2162. ［25］ACC/AHA. Guidelines for the Evaluation and Management of Heart Failure Report of the American College of Csrdiology/American Heart Association Task Force on Practice Guidelines (Committee on Evaluation and Management of Heart Failure)［J］. J Am Coll Cardiol, 1995, 26(5):1376-1398. ［26］Dickstein K, Cohen-Solal A, Filippatos G. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)［J］. Eur J Heart Fail, 2008, 10(10):933-989. ［27］National Clinical Guideline Centre (UK). Acute Heart Failure: Diagnosing and Managing Acute Heart Failure in Adults［J］. London: National Institute for Health and Care Excellence (UK); 2014. ［28］Adrian L, Werner C, Laufs U. ESC Guidelines 2016-Heart Failure［J］. Dtsch Med Wochenschr, 2017, 142(15):1123-1127. ［29］Yancy CW, Jessup M. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America［J］. J Card Fail, 2017, 23(8):628-651. ［30］中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性心力衰竭诊断和治疗指南［J］.中华心血管病杂志, 2010, 38(3):195-208. ［31］Rudusky BM. Aminophylline: exploring cardiovascular benefits versus medical malcontent［J］. Angiology, 2005, 56(3):295-304. ［32］Braunwald E, Fauci AS, Kasper DL, et al. Harrison′s Principles of Internal Medicine: Disorders of Immune-Mediated Injury［J］. New York: McGraw-Hill, 2001:1916. ［33］Nieminen MS, Bhm M, Cowie M.Executive summary of the guidelines on the diagnosis and treatment of acute heart failure: the Task Force on Acute Heart Failure of the European Society of Cardiology［J］. Eur Heart J, 2005, 26(4):384-416.